Ms Robyn Kruk AO is the Chair of Mental Health Australia and our guest blogger for this week.
Robyn’s experience incorporates positions as secretary/director-general of national and state agencies including the New South Wales Department of Premier and Cabinet and New South Wales Health. She established and worked as the inaugural CEO of the National Mental Health Commission and supported person centred whole of government mental health reforms at the national and state level. In 2005, Robyn was appointed to the Order of Australia as a Member for service to public administration. In 2018, Robyn was appointed Officer of the Order of Australia for service to public administration, particularly through mental health reform, and other distinguished service.

Time to act on mental health reform

For the last twelve months we have acknowledged the Productivity Commission Inquiry into Mental Health as a once in a generation opportunity for true and lasting mental health reform. 

This Inquiry is a clear and concerted opportunity for us all, especially state and federal governments which have indicated their passion for mental health and suicide prevention. It is an opportunity to make incremental, lasting and systemic reform. And it is also an opportunity to both realise and articulate the social and economic benefits a well-functioning mental health system can enable.  

Ahead of the Draft Report being released on 31 October, Mental Health Australia has helped facilitate a collaborative of more than 100 organisations to sign Charter 2020: Time To Fix Mental Health in a bid to ensure this Inquiry is acted on and implemented, unlike so many before it. 
Too many reports and reviews have fallen on deaf ears and for some reason it has been too hard to fix, and even define the mental health system, or agree to the desired outcomes for people experiencing mental ill health or supporting those that do. This is despite the fact that so many people with lived experience and practitioners have agreed on so much for so long, a point which will be prominent in the Inquiry’s findings.

How can it be that with so much agreement and bipartisan support, so little has been done? That’s not to say there haven’t been improvements, but often they have come at a cost elsewhere in the system, layered upon one another in a way that makes navigating access to services all the more complicated and less effective in driving enduring system change.

It is a fact that mental health in Australia has been the subject of a multitude of reviews and reports over the last 20 years all resulting in remarkably similar recommendations, yet little action or structured support for implementation.

Since 1993, there have been 12 major reviews (see below) as well multiple evaluations of National Mental Health Plans, over 30 reports undertaken by statutory authorities and a range of specific commissioned reviews.

While national mental health policy in response to these reviews has been considered world leading, this has not translated into a world leading system of high quality and comprehensive implementation. 
As a consequence, there is now a mishmash of services and initiatives delivered by a highly variable workforce dependent on postcode, not need. 

The good news though, is that key Federal Government figures have already spoken in strong terms about their personal commitment to improve the nation’s mental health, and suicide rates in particular. This is why when the final report for the Productivity Commission’s current Inquiry into Mental Health is handed down, state and federal governments will have a genuine opportunity to work in partnership with people with lived experience, and the sector, to implement real and lasting mental health reform. Reform which can, and will, deliver tangible actions to bring about significant and ongoing improvement in the lives of people with mental health issues.

The multifaceted nature of mental illness and mental health also requires a whole-of-government approach - a National Mental Health Agreement - as this is not just a health issue. 

Multiple reviews have called for improved intergovernmental arrangements including whole-of-government collaboration addressing the root causes of mental illness across the social determinants of health including housing and employment, streamlined funding/payment models, improved Commonwealth/state collaboration and clarified roles and responsibilities between governments. The absence of a clear national agreement enables cost shifting and inaction with little accountability and a sub optimal use of scarce resources. 

But expectations and accountabilities are changing, which is why the timing is right for real and lasting mental health reform. 

The current zero suicide aspiration at a Federal Government level is a serious attempt to make a difference. It also needs the support of states and territories to be effective, as well as the united and collaborative support of the sector, just like the Productivity Commission Inquiry into Mental Health does.

Australia’s mental health requires urgent and enduring action and in Charter 2020: Time To Fix Mental Health, more than 100 organisations have agreed on nine themes for reform and the need to implement this Inquiry. An Inquiry which is a once in a generation opportunity to realise our nation’s mental wealth, and to finally fix our ailing mental health system. 

We know that investing in mental health provides substantial personal and economic benefits. We know what to do, and we know there is agreement on what needs to be done. 

This is our Charter 2020: Time To Fix Mental Health    

• Strike a new National Agreement for Mental Health 
• Build a mental health system that is truly person led 
• Address the root causes of mental health issues
• Invest in early intervention and prevention  
• Fund Indigenous mental health, wellbeing and suicide prevention according to need  
• Provide integrated, comprehensive support services and programs 
• Expand community based mental health care
• Support workforce development  
• Build an evidence based, accountable and responsive system  

Warm regards,

Robyn Kruk

Chair, Mental Health Australia

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